Michael H Livingston, Sanjay Mahant, Bairbre Connolly, Ian MacLusky, Sophie Laberge, Lucia Giglia, Connie Yang, Ashley Roberts, Anna Shawyer, Mary Brindle, Simon Parsons, Cristina Stoian, J Mark Walton, Kevin E Thorpe, Yang Chen, Fei Zuo, Muhammad Mamdani, Carol Chan, Desmond Loong, Wanrudee Isaranuwatchai, Felix Ratjen, Eyal Cohen
IMPORTANCE: Clinical guidelines recommend that children with pleural empyema be treated with chest tube insertion and intrapleural fibrinolytics. The addition of dornase alfa (DNase) has been reported to improve outcomes in adults but remains unproven in children. OBJECTIVE: To determine if intrapleural tissue plasminogen activator (tPA) and DNase is more effective than tPA and placebo at reducing hospital length of stay in children with pleural empyema. DESIGN, SETTING, AND PARTICIPANTS: This multicenter, parallel-group, placebo-controlled, superiority randomized clinical trial included children diagnosed as having pleural empyema requiring drainage aged 6 months to 18 years treated at 6 tertiary Canadian children's hospitals...
April 1, 2020: JAMA Pediatrics